Kerala - Thiruvananthapuram   

Paediatric heart surgery programme at SAT

Thiruvananthapuram: The Sree Avittam Tirunal (SAT) hospital here is in the process of developing an independent Paediatric Cardiovascular and Thoracic (PCVT) surgery programme, to treat congenital heart problems in infants.

The programme, which has already been kicked off in a limited way, within the hospital’s meagre infrastructure and human resources, has been helping many families from the economically weaker sections to save a lot of money on what would have been expensive treatment options.

All major departments of Paediatrics, Paediatric Cardiology, Paediatric Surgery and Anaesthesiology are jointly handling the PCVT programme.

All invasive procedures for correcting congenital heart problems in infants admitted at SAT hospital were so far being done at the Cardio Thoracic surgery unit at Medical College Hospital (MCH), which is well equipped and has an extremely good record.

While there is no dedicated Paediatric Cardio thoracic surgery unit at SAT hospital, the institution has a good team of paediatric surgeons who are now undergoing training to repair congenital conditions like PDA (Patent Ductus Arteriosus), which does not need open-heart procedures.

About 10 per cent of congenital heart problems in infants seen at the SAT hospital are PDA cases.

In 2007, out of the 733 cases of congenital heart diseases, 92 cases related to PDA. PDA is a heart defect in which a channel between two major blood vessels fails to close, as it is supposed to, shortly after birth. Every baby is born with an open connection between the two major blood vessels originating from the heart, the aorta and the pulmonary artery.

If this channel does not close within three days, the blood that should be going through the aorta to the rest of the body gets back to the lungs through the channel (ductus arteriosus).

This is the third most common congenital heart problem in the world and is commonly seen in premature babies.

The only outward symptom in babies with PDA would be a heart murmur but this condition can lead to frequent lung infections or heart failure at a later stage.

“We have already done three cases of PDA using our basic facilities in the paediatric operation theatre. Normally, PDA cases here would be referred to either the MCH or the Sree Chitra Institute or the private sector, where the thoracoscopic surgery could be very expensive. We are doing the procedure totally free of cost. We intend to do a minimum of two cases every month,” says SAT Superintendent Zulficker Ahmed.

If at least half the PDA cases could be done in-house at SAT itself, it will also reduce the load of cardio thoracic surgeons at MCH, he points out.

Another procedure that SAT’s Paediatric surgery team is doing now is Video-Assisted Thoracoscopic Surgery (VATS).

This is a minimally invasive surgical technique which is used to diagnose and treat chest problems like Empyema, when pus or fluid collects inside the chest cavity.

During this surgery, small incisions are made in the chest and through one; a tiny fibre optic camera is inserted, while surgical instruments are introduced through the other incisions.

The surgeon is guided by the images transmitted by the camera to the video monitor.

The advantages of this procedure are that the post-operative pain and recovery period is reduced considerably. Some 11 cases of VATS have been done on children at SAT so far, absolutely free.

The Paediatric surgery department here has been performing laparoscopic surgeries on a routine basis for the past 18 months.

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